Non-contrast Cranial Computed Tomography can Change the Emergency Management of Nontraumatic Seizure Patients

Objective: The abnormal cranial computed tomography (CT) findings can change the emergency management in 9 - 17% of first seizure patients in the emergency department (ED). The aim is to evaluate the utility of non-contrast cranial CT on emergency management of non-traumatic ED seizure patients. Methods: The patients’ charts, who had been coded G-40 according to ICD-10, between 2013 and 2015 were reviewed. All adult patients who applied to the ED with epileptic activity were included. The patients who had trauma, inefficacy in medical record and absence of CT report and detected as not to have seizure were excluded. The socio-demographic and seizure characteristics, CT indications and interpretations and emergency outcomes of patients were investigated. Data were pointed out as numbers, percentages and mean ± standard deviations. Pearson and Fisher’s chi-square tests were used for evaluating of categorical variables. p value < 0.05 was accepted as significant. Results: 814 patients were included. 55.7% were male. Mean age was 50 years (50.50 ± 20.26 years, 95% CI). 56.5% had chronic and 43.5% had first seizure activity. New abnormal CT findings were detected in 33.9% of first and in 11.7% of chronic seizure patients. Total abnormal CT findings ratio was 52%. 14.7% of first seizure and 7.2% of chronic seizure patients’ emergency managements were changed due to abnormal CT findings. Totally, 10.4% of all patients’ emergency management was detected as changed. Conclusions: In the ED, either in first or in chronic seizure activity, non-contrast cranial CT scan is a practice that may change the patients’ emergency managements.

Chronic recurrent seizure, Computed tomography, Differential diagnose, Emergency management, First seizure

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